Provider Demographics
NPI:1861908576
Name:SCHULKE, MATTHEW (PMHNP-BC)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:
Last Name:SCHULKE
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 WATER ST
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-5333
Mailing Address - Country:US
Mailing Address - Phone:830-792-7505
Mailing Address - Fax:830-792-5771
Practice Address - Street 1:1300 DACY LN STE 120-130
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-4192
Practice Address - Country:US
Practice Address - Phone:512-392-8953
Practice Address - Fax:512-262-7505
Is Sole Proprietor?:No
Enumeration Date:2017-12-18
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX899253163W00000X
TX1175658363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse